New CPR technique renders safety in times of COVID-19

Germany: Leg-heel chest compression may be an effective alternative to manual chest compression in present scenario of COVID-19 pandemic, finds a recent study reported in medRiv ahead of peer review. The use of unshod heel of the foot for performing cardiopulmonary resuscitation (CPR) instead of hands may help medical professionals to increase their distance from the patients, thereby, avoiding coronavirus infection. 

According to the study, potential spread of breath droplets from the patient to the person performing CPR will likely be minimized with leg-heel compression.

SARS-CoV-2 is a highly contagious virus that causes COVID-19. Its particles are transmitted mainly via aerosols and droplets. The International Liaison Committee on Resuscitation (ILCOR) state chest compression having the potential to generate aerosol. Likewise, the World Health Organisation (WHO) lists cardiopulmonary resuscitation (CPR) as an aerosol generating procedure (AGP).

Distance is known to be an important risk factor for virus transmission since the concentration of SARS-CoV-2 has been shown to diminish with increasing distance from a patient. In some circumstances like bystander CPR, increased distance is the only adequate form of readily available protection against virus transmission. 

Considering this, Matthias Ott, Klinikum Stuttgart, Stuttgart, Germany, and colleagues aimed to valuate leg-heel chest compression without previous training as an alternative for medical professionals and its effects on distance to potential aerosol spread during chest compression.

For the purpose, the researchers had 20 medical professionals to perform standard manual chest compression followed by leg-heel chest compression after a brief instruction on a manikin. They compared percentage of correct chest compression position, percentage of full chest recoil, percentage of correct compression depth, average compression depth, percentage of correct compression rate and average compression rate between both methods.

In a second approach, potential aerosol spread during chest compression was visualized.

"We found no significant difference between manual and leg-heel compression. The distance to potential aerosol spread could have been increased by leg-heel method," wrote the authors.

"Under special circumstances like COVID-19-pandemic, leg-heel chest compression may be an effective alternative without previous training compared to manual chest compression while markedly increasing the distance to the patient," they concluded. 

Reference:

The study titled, "Leg-heel chest compression as an alternative for medical professionals in times of COVID-19," is reported in medRiv.

DOI: https://www.medrxiv.org/content/10.1101/2021.03.09.21253220v1